Weisberg L A, Stazio A
Department of Neurology and Psychiatry, Tulane Medical School, New Orleans, LA 70112.
Comput Med Imaging Graph. 1989 Jul-Aug;13(4):355-61. doi: 10.1016/0895-6111(89)90216-4.
The clinical and computed tomographic findings in 25 patients with parietal lobe hematomas are discussed. Six patients had anterior-lateral parietal hematomas (18 to 36 mm). These patients were normotensive. No etiology was delineated even when angiography was utilized. Six patients had medial parietal hematomas (12 to 24 mm) with extension to the thalamus. Two patients were normotensive and six were hypertensive. Three patients had posterior parietal hematomas (10 to 18 mm). These patients were hypertensive. Eight patients had parietal hematomas extending to the temporal and frontal region (30 to 60 mm). Three of these patients died. Four patients were normotensive and four were hypertensive. One of these normotensive patients had cerebral metastases. Two patients had parietal hematomas which extended to the occipital region (20 to 34 mm). These patients were normotensive. Peripheral rim enhancement was demonstrated on follow-up CT scan (performed 2 to 4 weeks after the initial study) in 14 of 21 cases. On follow-up CT of the 21 surviving patients with parietal hematomas (excluding the case due to metastases) performed more than 4 weeks after the clinical ictus, 14 appeared hypodense and 7 appeared isodense. Residual neurological deficit and recurrent seizures were more frequent if the hematoma "aged" to a hypodense appearance.
本文讨论了25例顶叶血肿患者的临床及计算机断层扫描结果。6例患者为前外侧顶叶血肿（18至36毫米）。这些患者血压正常。即使采用血管造影术也未明确病因。6例患者为内侧顶叶血肿（12至24毫米）并延伸至丘脑。2例患者血压正常，6例患者高血压。3例患者为后顶叶血肿（10至18毫米）。这些患者高血压。8例患者顶叶血肿延伸至颞叶和额叶区域（30至60毫米）。其中3例患者死亡。4例患者血压正常，4例患者高血压。这些血压正常的患者中有1例有脑转移瘤。2例患者顶叶血肿延伸至枕叶区域（20至34毫米）。这些患者血压正常。在21例中的14例患者的随访CT扫描（在初次检查后2至4周进行）上显示有外周边缘强化。在临床发作后4周以上对21例存活的顶叶血肿患者（不包括因转移瘤导致的病例）进行随访CT检查时，14例表现为低密度，7例表现为等密度。如果血肿“老化”为低密度表现，则残留神经功能缺损和癫痫复发更为常见。
